Reason for Speech Language Pathology Referral: 74 year old male complaining of intermittent coughing with and without PO intake, which had progressively worsened over the previous two months, pills getting stuck in his throat, and increased hoarseness.

Previous Modified Barium Swallow Study: An MBSS was performed on 12/07/12 which found penetration to the level of the vocal cords with thin consistency liquids, no aspiration, upper esophageal motility within normal limits, decreased cohesion during bolus formation, premature loss over tongue base, impaired anterior and superior laryngeal movement, and mild intermittent incomplete epiglottic inversion.